Massachusetts doctor loses court battle for medical aid in dying but plans to appeal the decision

Caregiver end of life care nursing home palliative care
A court has ruled that Massachusetts physicians aren't protected against prosecution if they prescribe lethal medication for dying patients. (Getty/KatarzynaBialasiewicz)

A Massachusetts doctor, diagnosed with stage 4 metastatic prostate cancer, says he will continue his legal fight to ensure his access to medical aid in dying.

Roger Kligler, M.D., said he will appeal a decision (PDF) by a Massachusetts Superior Court judge that terminally ill patients do not have a constitutional right to medical aid in dying, also called physician-assisted suicide. The court did rule that doctors may provide advice and information about medical aid in dying to terminally ill, competent adults.

Kligler, a retired Cape Cod physician, and Alan Steinbach, M.D., who treats terminally ill patients, had filed the lawsuit asserting the state constitution and existing state law allows medical aid in dying whereby physicians can prescribe a lethal dose of medication to terminally ill patients to self-administer.

Compassion & Choices, an organization that advocates for the rights of terminally ill patients, also joined in the lawsuit and said in an announcement that it will appeal the court’s dismissal of all but one count in the lawsuit.

The court did rule in the plaintiffs’ favor in allowing doctors to advise terminally ill patients about medical aid in dying without fear of prosecution. However, it does not preclude state law enforcement officials from prosecuting physicians who prescribe lethal medications for dying patients who want to end their own lives.

“This setback is disheartening, but we will continue this legal battle,” Kligler said in the announcement. “As a physician who has treated numerous terminally ill adults, I know many of them would want medical aid in dying as an option to peacefully end their suffering. I do not know if I would use this option, but I want it for myself if my suffering becomes intolerable at the end of my life.”

Kligler filed the lawsuit with Steinbach, who seeks to provide information about medical aid in dying and write prescriptions for the medication to his terminally ill patients.

The court was not unsympathetic. "This court has immense compassion for Dr. Kligler's desire to avoid a potentially painful death and for Dr. Steinbach's desire to ease his patients' suffering," the ruling stated.

But the court rejected the argument that medical aid in dying should not be considered involuntary manslaughter and doctors should be protected against prosecution.

The court said the legislature, not the courts, should decide the controversial issue, which would allow detailed restrictions to protect against potential abuse of such a law. There are strong arguments both for and against, the court said.

Massachusetts voters in 2012 narrowly rejected a ballot question that would have made medical aid in dying legal in the state, with 51% of voters against it and 49% in favor.

RELATED: Two state medical societies drop opposition to medical aid-in-dying

Medical aid in dying is authorized in 10 jurisdictions: California, Colorado, Hawaii, Maine, Montana, New Jersey, Oregon, Vermont, Washington and the District of Columbia.

While disappointed in the court decision, proponents said they were happy the court had ruled that doctors can discuss medical aid in dying with patients.

“The silver lining is the attorney general’s office abandoned its position that doctors could not share information with patients about the full range of end-of-life care options, including medical aid in dying in the 10 jurisdictions where it is authorized. And the court concurred that doctors have this free speech right,” said Kevin Díaz, chief legal advocacy officer and general counsel for Compassion & Choices.

RELATED: Doctors divided, AMA to continue to study physician aid-in-dying

While proponents of medical aid in dying were disappointed by the court’s ruling, Americans United for Life praised the decision.

“It's a victory for common sense that Massachusetts has affirmed that there is no constitutional right to suicide in the state,” Tom Shakely, chief engagement officer for the national pro-life organization, said in a statement.

However, he was concerned the court had legitimized medical aid in dying with its decision to let doctors discuss the issue with patients.

“MAiD [medical aid in dying] is simply a marketing term that papers over the reality of suicide and euthanasia that the process makes possible,” he said.

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